The 2013 ICRE wrapped on Saturday after three days of intense discussion on the future of medical education. The conference ended with key presentation on resident duty hours, indigenous health and innovative practices from researchers at the University of Calgary, followed by a gala to recognize the achievement of this year’s award winners.

Innovations at the University of Calgary:

Saturday featured a showcase on innovations in residency education presented by researchers at the University of Calgary. Eleven groups shared their findings on a diverse set of issues ranging from the implementation of scenario based learning, to a seminar on breaking bad news.

“One of our biggest challenges in effectively implementing change is getting the information out in the first place. This conference represents an important opportunity to share our learnings and best practices with colleagues across the country and around the world,” says Dr. Maureen Topps, Associate Dean Postgraduate Medical Education at the University of Calgary, and presenter at ICRE 2013. “As they say, many minds are better than one, and this conference allows the best minds to come together to explore enhanced models for the education of future medical professionals.”

Indig­enous Health:

Saturday also featured a workshop on the Royal College’s Indigenous health values and principles statement, and the implications of that statement on medical education. This highly-rated session discussed the effects of social determinants, government policies and historical legacies on the health of Indigenous Peoples as well as the existence of personal and structural racism and oppression in the health system. “The popularity of this session indicated to us a need for further discussion on this important topic,” says Danielle Fréchette with the office of health policy and external relations at the Royal College. “Our next step will be to expand the workshop series, including developing tools to help educators and learners advance cultural safety.”

Resident Duty Hours:

During the conference, a panel symposium (Drs. Ramona Kearney, Joshua Tepper, Najma Ahmed, Caroline Lacroix, Kaif Pardhan, and panel chairs Drs. Jason Frank and Kevin Imrie), representing a variety of perspectives, offered participants an opportunity to discuss the final report and recommendations of a pan-Canadian project on resident duty hours. The final report from the National Steering Committee on Resident Duty Hours, as presented during the conference, emphasizes a flexible approach to resident duty hour regulation, with a greater focus on developing appropriate fatigue management plans rather than regulating a specific number of consecutive hours. There was wide agreement for this approach and the report’s overall recommendations in the 200 delegate audience at the panel symposium.

The panel also provided an opportunity to begin discussing perspectives and ideas around the challenges and feasibility of implementation and to ensure solutions focusing on addressing fatigue management are tailored to specific hospital environments.

Additional research presented during the conference suggests that, across Canada, the context of resident work hours varies from province to province. Furthermore, early outcome data from other jurisdictions internationally and nationally (Quebec, Brazil) highlight concerns for inflexible approaches to duty hour regulation in other jurisdictions where implementation may be underway. Research coming out of Brazil reported a high prevalence of sleep disturbance and burnout among residents, including two unfortunate deaths among residents in one hospital within a two year period. Early data from Quebec points to emerging concerns worthy of more attention for policymakers, including dissatisfaction and higher rates of burnout among residents with duty hour regulations implemented recently in the province (16 hour limit). Research presented during the conference suggest that hour restrictions may run the risk of replacing one problem (acute sleep deprivation) with others (chronic sleep deprivation, work/life balance, etc.).

ICRE 2014, with the theme Residency Education and Care in the Digital Age, will “focus on aligning medical education with the realities of the 21st century,” says chair Dr. Jason Frank. “Participants return year after year to ICRE because medical education continuously faces new challenges, and the Royal College is an acknowledged global leader in facilitating discussion and innovation. Next year’s conference will deliver on each of these elements, along with an increased focus on extending the global reach of ICRE.” ICRE 2014 will take place October 23-25 in Toronto.